Cardiovascular Effects of Dipeptidyl Peptidase-4 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists: a Review for the General Cardiologist

Kershaw V. Patel, Ashish Sarraju, Ian J. Neeland, Darren K. McGuire

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Purpose of Review: Results from cardiovascular (CV) outcome trials have revealed important insights into the CV safety and efficacy of glucose-lowering agents, including dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide-1 receptor agonists (GLP-1RA). Recent Findings: Among patients with T2DM, DPP-4i have no significant effect on risk of major adverse CV events (MACE: CV death, myocardial infarction, or stroke) with mixed results regarding risk for heart failure (HF). While sitagliptin and linagliptin have neutral effects on HF risk, saxagliptin significantly increases the risk of HF. The CV safety of the GLP-1RA class of medications has been clearly demonstrated, and select agents, such as liraglutide, semaglutide, albiglutide, and dulaglutide, reduce the risk of MACE in patients with T2DM and established CV disease. Summary: CV outcome trials have demonstrated CV safety but not incremental efficacy for DPP-4i in most cases. Select GLP-1RA have proven efficacy for MACE and should be considered by cardiologists for CV risk mitigation in the care of patients with T2DM and established CV disease.

Original languageEnglish (US)
Article number105
JournalCurrent Cardiology Reports
Volume22
Issue number10
DOIs
StatePublished - Oct 1 2020

Keywords

  • Atherosclerotic cardiovascular disease
  • Dipeptidyl peptidase-4 inhibitors
  • Glucagon-like peptide-1 receptor agonists
  • Heart failure
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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